肺炎支原体感染患儿SAA、CRP、NLR、PLR水平与病情进展及体液免疫的关系

Correlation of SAA,CRP,NLRand PLRwith disease progression and humoral immunity in children infected with mycoplasma pneumoniae

目的研究肺炎支原体感染患儿淀粉样蛋白A(SAA)、C-反应蛋白(CRP)、中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)水平与病情进展及体液免疫的关系。方法2021年9月至2023年9月收治的肺炎支原体肺炎患儿120例作为病例组,同期进行体检的128例健康儿童作为健康对照组,比较2组血清SAA、CRP、外周血NLR、PLR水平及体液免疫指标;将病例组根据病情严重程度分为轻症组(74例)、重症组(46例),比较不同病情严重程度肺炎支原体肺炎患儿血清SAA、CRP、外周血NLR、PLR水平及体液免疫指标,采用Pearson相关分析血清SAA、CRP、外周血NLR、PLR水平与体液免疫指标的相关性,采用受试者工作特征曲线(ROC)分析血清SAA、CRP、外周血NLR、PLR对重症肺炎支原体肺炎的诊断价值。结果病例组血清SAA、CRP、免疫球蛋白M(IgM)、外周血NLR、PLR水平高于健康对照组,血清免疫球蛋白A(IgA)水平低于健康对照组(P<0.05)。重症组血清SAA、CRP、IgA、IgM、外周血NLR、PLR水平高于轻症组(P<0.05)。肺炎支原体肺炎患儿血清SAA、CRP、外周血NLR、PLR水平与血清IgA、IgM水平呈正相关关系(R=0.640、0.418、0.611、0.483、0.527、0.428、0.553、0.541,P<0.05)。SAA、CRP、NLR、PLR四者联合诊断重症肺炎支原体肺炎的曲线下面积(AUC)值高于四者单独检测(P<0.05);敏感度比较,SAA、PLR及联合高于CRP、NLR,NLR高于CRP(P<0.05);特异度比较,CRP、NLR及联合高于SAA,CRP、联合高于NLR、PLR(P<0.05)。结论肺炎支原体肺炎的发生和发展均可引起血清SAA、CRP、外周血NLR、PLR水平及体液免疫指标水平变化,肺炎支原体肺炎患儿血清SAA、CRP、外周血NLR、PLR水平与体液免疫指标具有明显相关性,同时血清SAA、CRP、外周血NLR、PLR四者联合对重症肺炎支原体肺炎的诊断价值较好。

Objective To study the correlation of serum amyloid A(SAA),C-reactive protein(CRP),neutrophil to lymphocyte ratio(NLR),and platelet to lymphocyte ratio(PLR)with disease progression and humoral immunity in children infected with mycoplasma pneumoniae.Methods From SeptembeR2021 to SeptembeR2023,120 children with mycoplasma pneumoniae pneumonia admitted to ouRhospital were used as the case group,and 128 healthy children who underwent physical examination in ouRhospital during the same period were used as the healthy control group.Serum SAA,CRP,peripheral NLR,PLRand humoral immunity parameters of the two groups were compared.According to the severity of the disease,children in the case group were divided into the mild group(74 cases)and severe group(46 cases).Serum SAA,CRP,peripheral NLR,PLRand humoral immunity parameters were compared.Pearson correlation was used to analyze the correlation of serum SAA,CRP,peripheral NLR,and PLRwith humoral immune.ReceiveRoperating characteristic(ROC)curves were plotted to analyze the diagnostic value of serum SAA,CRP,peripheral NLR,and PLRin severe mycoplasma pneumonia.Results Serum SAA,CRP,immunoglobulin M(IgM),peripheral NLRand PLRin the case group were significantly higheRthan those of the healthy control group,and the serum immunoglobulin A(IgA)was significantly loweR(P<0.05).Serum SAA,CRP,IgA,IgM,peripheral NLRand PLRin the severe group were significantly higheRthan those of the mild group(P<0.05).Serum SAA,CRP,peripheral NLRand PLRwere positively correlated with serum IgA and IgM in children with mycoplasma pneumoniae pneumonia(R=0.640,0.418,0.611,0.483,0.527,0.428,0.553,and 0.541,respectively;P<0.05).The area undeRthe curve(AUC)of SAA,CRP,NLRand PLRin the combined diagnosis of severe mycoplasma pneumoniae pneumonia was significantly higheRthan that of theiRsingle detection(P<0.05).The sensitivity of single detection of SAA and PLRand theiRcombination in diagnosing severe mycoplasma pneumoniae pneumonia was significantly higheRthan that of CRP and NLR,and the sensitivity of NLRwas significantly higheRthan that of CRP(P<0.05).The specificity of single detection of CRP and NLRand theiRcombination in diagnosing severe mycoplasma pneumoniae pneumonia was significantly higheRthan that of SAA,and the specificity of CRP and the combination was significantly higheRthan that of NLRand PLR(P<0.05).Conclusion The occurrence and development of mycoplasma pneumoniae pneumonia change serum SAA,CRP,peripheral NLR,PLRand humoral immunity parameters.Serum SAA,CRP,peripheral NLRand PLRin children with mycoplasma pneumoniae pneumonia are significantly correlated with humoral immunity.The combination of serum SAA,CRP,peripheral NLRand PLRoffers a betteRdiagnostic value foRsevere mycoplasma pneumoniae pneumonia.